Association of minimum dietary diversity with anaemia among 6-59 months' children from rural India: An evidence from a cross-sectional study.

Introduction: Anaemia is one of the micronutrient deficiency disorders that have global public health implications. The present study aims to determine the association of minimum dietary diversity (MDD) with anaemia among children aged 6-59 months in rural North India. Methods: In Rohtak (a north Indian city), a cross-sectional survey was conducted in 2018-19 (n = 266). Univariate and bivariate analyses were performed. The Chi-square test was used for assessing the significance level during bivariate analysis. Further, multivariable regression analysis was used for determining the factors for anaemia prevalence among children aged 6-59 months. Results: About 62.4% (n = 166) of the children aged 6-59 months were found to have anaemia in the study area. The prevalence of MDD was 35.3% (n = 94). It was found that children with no MDD have a higher prevalence of moderate (42% vs. 25.5%; P < 0.001) and severe (12.8% vs. 8.5%; P < 0.001) anaemia. It was revealed that the children with no MDD had a significantly higher likelihood of being anaemic than children with MDD in model-1 [aOR: 2.09; CI: 1.23, 3.55] and model-3 [aOR: 1.70; CI: 1.01, 3.01]. Children with mothers who never attended school had significantly higher odds for anaemia in reference to those children whose mothers ever attended school in model-2 [aOR: 3.62; CI: 2.07,6.34] and model-3 [aOR: 3.00; CI: 1.62,5.56]. Conclusion: Measures to alleviate under-five anaemia should include empowering and educating women, expanding access to supplementation, fortification programmes, and promoting and raising awareness about feeding diverse foods, while also considering the socioeconomic status.

Pre-exposure Prophylaxis (PrEP) Awareness, Willingness to Use, and Preferred Places for Access Among the Cambodian Female Entertainment Workers: A Cross-Sectional Study.

The aim of the study was to determine the awareness, desire to use, and preferred providers of pre-exposure prophylaxis (PrEP) among Female Entertainment Workers (FEWs) aged 18-35 years in Cambodia's Phnom Penh region. Of 1003 FEWs, 31.8% of them had heard of PrEP. When informed about PrEP, 67.4% said they would use PrEP and the most preferred location to access PrEP was a local non-governmental organization (NGO) (63.2%), followed by a government clinic/center (39.8%), ART clinic (26.5%), pharmacy (20.7%), and CBO (14.8%). FEWs who had heard about PrEP (aOR: 2.46; CI: 1.79-3.39) and those with no additional income source other than sex work (aOR: 1.53; CI: 1.16-2.02) were more likely to express their willingness to use PrEP. When the country is in the process of making provisions for PrEP, the study urges policymakers and programmers to take steps towards creating awareness about PrEP among key populations such as FEWs and its availability preferably through local NGOs and government clinics.

Awareness about Human Papillomavirus Vaccine and Its Uptake among Women from North India: Evidence from a Cross-Sectional Study.

OBJECTIVE: This study aims to estimate the prevalence of human papillomavirus (HPV) vaccine usage and determine the factors for awareness about HPV vaccine among women in reproductive age group. METHODS: This is a cross-sectional survey under a cervical cancer prevention study. The sample size was 1020 women, aged 15-49 years [550 in Delhi and 470 in Rohtak]. Bivariate analysis and Fisher exact test along with binary logistic regression analysis were used to determine the factors for awareness. RESULT: About 18.0 % [Delhi: 24.2 % and Rohtak: 10.9 %] of the respondents had heard about the vaccine against cervical cancer. The women aged more than 30 years [AOR: 1.35; CI: 0.94, 1.94] were more likely to be aware of cervical cancer vaccine as compare to women of 30 years and less. However, the women from Rohtak [AOR: 0.90; CI: 0.48, 1.66] were less likely to be aware of vaccine against cervical cancer in reference to women aged 30 years and more [AOR: 1.61; CI: 1.01, 2.56] from Delhi. About 0.6 % [Delhi: 1.1 % and Rohtak: 0.0 %] of the respondents had received HPV vaccine. CONCLUSION: Women tend to have limited knowledge about cervical cancer vaccine and immunisation practices. The women's demographic makeup varied significantly between the two sites, i.e , Rohtak and Delhi, which had an impact on how well they understood and utilised the cervical cancer vaccination. It is worth mentioning that none of the women from Rohtak had received the immunisation. The awareness of the cervical cancer vaccine among women from the Rohtak was lower than the Delhi women.

Outdoor Physical Activity in an Air Polluted Environment and Its Effect on the Cardiovascular System-A Systematic Review.

Air pollution is a global public health threat. Evidence suggests that increased air pollution leads to increased cardiovascular morbidity and mortality. The aim of this review was to systematically review and synthesize scientific evidence to understand the effect of performing outdoor physical activity (PA) in a polluted environment on cardiovascular outcomes. This review was developed and reported in accordance with the PRISMA guidelines. Electronic searches in Embase, Web of Science, and PubMed were undertaken through March 2021 initially, and later updated through to 31st January 2022, for observational studies published in peer-reviewed journals that report cardiovascular mortality or morbidity due to outdoor PA in air polluted environment. These searches yielded 10,840 citations. Two reviewers independently reviewed each citation for its eligibility. Seven studies were found to be eligible. Of these, five were cohort studies and two were cross-sectional studies. Pollutants measured in the selected studies were Particulate Matter (PM)-PM10, PM2.5, nitrogen oxides (NOx), and ozone (O3). The most common study outcome was myocardial infarction, followed by cardiovascular mortality, hypertension and heart rate variability. Six studies emphasized that the PA has beneficial effects on cardiovascular outcomes, though air pollutants attenuate this effect to an extent. Two studies showed that walking, even in the polluted environment, significantly reduced the heart rate and heart rate variability indices. The beneficial effects of outdoor PA outweigh the harmful effects of air pollution on cardiovascular health, though the benefits reduce to an extent when PA is carried out in a polluted environment. Because a limited number of studies (n = 7) were eligible for inclusion, the review further emphasizes the critical need for more primary studies that differentiate between outdoor and indoor PA and its effect on cardiovascular health.

Prevalence and Predictors of Cervical Cancer Screening among Reproductive Age Group Women: Evidence from Cross-Sectional Study in Rohtak and Delhi.

BACKGROUND: The present study aims to estimate the prevalence and determine the factors for cervical cancer screening among women in the reproductive age group in Delhi and Rohtak, India. METHODS: The data were utilized from a survey conducted as part of a larger study to increase the access to cervical cancer screening and care by MAMTA-Health Institute for Mother and Child in collaboration with the Health Departments of Palam, New Delhi, and Rohtak, Haryana between 2015 and 2017. Data pertaining to the socio-economic and demographic information along with the information related to cervical cancer screening were utilized for the present study. The sample size was 1020 women in reproductive age group. Descriptive statistics (percentage and frequency distribution), bivariate analysis along with multivariable analysis were done to represent the results.  The Fisher exact test was used to test the level of significance during bivariate analysis. RESULTS: About 35.2% [Delhi: 44.9% and Rohtak: 23.8%] of the respondents had heard about cervical cancer screening. Further about 3.9% [Delhi-2.9% and Haryana-5.1%] had screened for cervical cancer. Women who had heard about cervical cancer were five times more likely to go for screening [aOR: 5.27; CI: 2.53,10.96]. It was found that women over 30 years of age had 12.04 significantly higher  odds of going for cervical cancer screening in reference to women aged 30 years and less [aOR: 12.04; CI: 3.01,53.20]. Women from households with a monthly income of more than 15000 had 2.98  significantly higher odds of going for cervical cancer screening in reference to women from households with an income of 5000 and less [aOR : 2.98; CI: 1.12,9.09]. CONCLUSION: Findings suggest that awareness about cervical cancer screening test along with its thorough knowledge about its benefits would be an effective intervention to increase the uptake of cervical cancer screening.

Women's Knowledge on Cervical Cancer Risk Factors and Symptoms: A Cross Sectional Study from Urban India.

BACKGROUND: Early-stage cervical cancer diagnoses may be the consequence of timely medical care in the presence of symptoms which can be linked to awareness of the symptoms and risk factors. This study aims to determine the knowledge about risk factors and symptoms of cervical cancer and associated factors among women aged 20-49 years. METHODS: Data were utilized from the survey under the intervention "Increasing access to cervical cancer screening and care through the community-centric continuum of care initiative in India" (2015). The sample size was 1,020 women in the age group of 20-49 years. Descriptive statistics, along with bivariate analysis, was done to represent the preliminary results. Multivariable regression analysis was used to represent the estimates. RESULTS: About 40.1% [Delhi: 56.9% and Rohtak: 20.4%] and 45.5% [Delhi: 52.2% and Rohtak: 37.7%] of respondents had good knowledge about risk factors and symptoms of cervical cancer, respectively. Respondents with primary educational status had an 86% significantly higher likelihood for good knowledge about identified risk factors of cervical cancer [ adjusted odds ratio (aOR): 1.86; CI: 1.12-3.10]. Respondents who were married or widowed/divorced/separated had significantly higher odds for good knowledge about identified risk factors and symptoms of cervical cancer in reference to respondents who were never married. Respondents from Rohtak had 72% and 35% significantly higher odds for good knowledge about identified risk factors [aOR:0.28; CI: 0.21,0.39] and symptoms [aOR:0.65; CI: 0.48,0.88] of cervical cancer, respectively, in reference to respondents from Delhi. CONCLUSION: Overall awareness about cervical cancer and Human papillomavirus (HPV) as the causative agent was low, more so in Rohtak. This is extremely worrisome as blocking HPV infection is one of the most effective ways to prevent cervical cancer. Moreover, the knowledge about the risk factors and symptoms of cervical cancer is also inadequate, particularly in women from Rohtak.

Altered Sleep Duration and Poor Quality of Sleep Among Pharmacy Students Amidst COVID-19 Lockdown: A South-Indian Study.

Introduction/background: The nationwide lockdown enforced due to the spread of coronavirus disease-2019 had a definite impact on sleep. Objective: To observe any changes in the duration, pattern and quality of sleep among pharmacy students due to the lockdown. Methods: A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the ethical committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analyzed using STATA version 16.0. Results and Discussion: Out of 310 participants, the study revealed an increase in the time needed to fall asleep (p value < 0.001) and in the total duration of sleep (p value < 0.001). A delay in the time of sleep in the morning (p value < 0.001) and at night (p value < 0.001) was also one among the many significant results. The incidences of jerky leg movements (p value < 0.001), snoring (p value < 0.001), frequent nightmares (p value < 0.001) and anxiety (p value < 0.001) were also increased as a direct effect of the lockdown. Conclusion: The study has confirmed the detrimental impact of the lockdown on sleep among pharmacy students. All attributes of sleep duration and sleep quality have achieved statistical significance signifying the need to develop cognitive behavioral interventions and prevent the worsening of mental health amidst the COVID-19 era.

Scoping Review of Intervention Strategies for Improving Coverage and Uptake of Maternal Nutrition Services in Southeast Asia.

Maternal undernutrition can lead to protein-energy malnutrition, micronutrient deficiencies, or anemia during pregnancy or after birth. It remains a major problem, despite evidence-based maternal-nutrition interventions happening on ground. We conducted a scoping review to understand different strategies and delivery mechanisms to improve maternal nutrition, as well as how interventions have improved coverage and uptake of services. An electronic search was conducted in PubMed and Google Scholar for published studies reporting on the effectiveness of maternal-nutrition interventions in terms of access or coverage, health outcomes, compliance, and barriers to intervention utilization. The search was limited to studies published within ten years before the initial search date, 8 November 2019; later, it was updated to 17 February 2021. Of 31 studies identified following screening and data extraction, 22 studies were included for narrative synthesis. Twelve studies were reported from India and eleven from Bangladesh, three from Nepal, two from both Pakistan and Thailand (Myanmar), and one from Indonesia. Nutrition education and counselling, home visits, directly observed supplement intake, community mobilization, food, and conditional cash transfer by community health workers were found to be effective. There is a need to incorporate diverse strategies, including various health education approaches, supplementation, as well as strengthening of community participation and the response of the health system in order to achieve impactful maternal nutrition programs.